Rural & Remote Health

SATMED: Legal Aspects of the Physical Layer of Satellite-Telemedicine

by Stephen Rooke

Significant disparities exist between the availability of physicians and health care specialists in urban and rural... more Significant disparities exist between the availability of physicians and health care specialists in urban and rural areas, particularly in developing countries. For example, the concentration of medical specialists in Nairobi, Kenya, is 147 times higher than in Kilifi, a relatively large, but rural region. Emerging telemedicine technologies would enable doctors located in urban areas and elsewhere around the globe to serve rural patients. However, the limited availability of telecommunications infrastructure and technology necessary for telemedicine in rural areas inhibits the deployment of such health care applications. For example, in Namtumbo, Tanzania, a region with over 190,000 people, there are no doctors and none of the medical facilities have access to any type of telephone connection. Only twenty percent of Tanzania's health districts are connected by landline telephone.

Satellites' ability to bridge gaps in telecommunications infrastructure gives them a unique capacity to also bridge the urbal-rural health care divide by making telemedicine applications available to rural patients and medical professionals worldwide. Unfortunately, international law provides an expansive grant of national sovereignty over electromagnetic spectrum that supersedes state obligations to provide access to health care. As a result, the physical equipment necessary to provide telemedicine services to rural patients is subject to national regulatory regimes that prevent the widespread and cost-effective availability of life-saving technology.

This paper identifies the body of international law governing satellite-telemedicine including outer space law; conventions governing economic, social and cultural rights and the right to health care; and international telecommunications law including the ITU Constitution, Tampere Convention, and the Global Mobile Personal Communication by Satellite Memorandum of Understanding. It then concludes that an additional international undertaking to eliminate national barriers to entry for satellite-telemedicine technology is necessary.

De Roiste, A., Gavin, A. & Nic Gabhainn, S. (2008). Urban and rural patterns in adolescent alcohol consumption in Ireland. National Institute of Health Sciences Research Bulletin, 4(4), s7-s8

by Saoirse Nic Gabhainn

Midwives' Competence: is It Affected by Working In a Rural Location?

by Fiona Harris

A model program for hepatitis B vaccination and education of schoolchildren in rural China

by Jonathan Chen

The Adoption and Use of Health Information Technology in Rural Areas: Results of a National Survey

by Michael Lichter

TOPS - designing digital tools for personal and social interaction

by Alasdair Mort

Co-authored with Paul McNamee, Lorna Philip and Pat Schofield (University of Aberdeen), Vicki Hanson (University of Dundee) and Gaener Rodger (University of the Highlands and Islands). Paper presented at Digital Engagement 11; 15-17th November 2011, Newcastle, UK

In this paper we describe the TOPS project, which aims to generate digital engagement tools to aid personal and social... more In this paper we describe the TOPS project, which aims to generate digital engagement tools to aid personal and social interaction between older adults and their care providers. TOPS focuses specifically on rural older adults who experience chronic pain – this responds to research priorities and to gaps identified in the health, social and technological literature. We outline the project’s methods, strategy for technology design and present feedback from initial scoping research.

The inclusion of parents or carers in the consultation process of developing health-promotion activities in the Australian context.

by Paul Bennett

Co-authored with - Gladman, J.
(2012) Health Education Journal, in Print

Objective: Patterns of health behaviour and lifestyle established in childhood carry on into adulthood.
Parents... more Objective: Patterns of health behaviour and lifestyle established in childhood carry on into adulthood.
Parents and carers have strong influences on the establishment of these patterns. Despite such influences,
parents and carers are often omitted from the planning process in health-promotion and early intervention
activities. This paper examines the literature to quantify the amount of consultation that occurs.
Method: A systemic review of the available literature was conducted of papers published in English
between 1998 and 2008 using OVID, Medline, CIAP, CINAHL, PsycINFO, SPORTDiscus, INFORMET and
PubMed databases. The search was not limited to age; however, some papers indicted that their research
were restricted to children over the age of five.
Results: Three hundred and thirty one articles were retrieved of which 32 met the inclusion criteria. It
was found that parents and carers are reliable and accurate reporters of the objective components of their
child’s health, such as physical functioning, but unreliable when it comes to subjective components including
pain and emotional psychosocial functioning of their children. However, parents and carers are often omitted
or at best superficially included in the development of health-promotion and early intervention programmes
in Australia.
Conclusions: The lack of consultation with parents and carers in health-promotion and early interventions
programmes by policy makers, programme developers and health advocates results in decreased consumer
ownership, dissatisfaction with service delivery and creates barriers to engagement. Without adequate and
appropriate engagement of parents and carers, early interventions and health-promotion programmes will
result in superficial and short-term health outcomes.
Keywords
carers and children, health promotion, parents, perception

ENRICHing the rural clinical experience for undergraduate health science students: A short report on inter-professional education in Broken Hill - Brief Report

by Paul Bennett

Co-authored with - Bolte, K. and Moore, M.
AJRH, in print

This paper depicts the development, implementation
and ‘value-adding’ component of the Enhanced Rural more This paper depicts the development, implementation
and ‘value-adding’ component of the Enhanced Rural
Inter-Professional Cultural Health (ENRICH) Program.
ENRICH is a unique program that complements the
clinical competency focus of university curricula for
health science students. The Broken Hill University
Department of Rural Health (BHUDRH) hosts health
science students from multiple Australian universities
and offers a unique rural/remote placement experience.
ENRICH was developed by BHUDRH in response to an
identified need to broaden the perspectives of health
science students and to encourage the incorporation of a
holistic view of their patients within their practice.

Staying healthy: how farmers and fishers maintain good health in difficult times

by Karen Willis

Staying healthy: the case of cotton and cane growers in Australia

by Karen Willis

Planning of a community‐based approach to injury control and safety promotion in a rural community

by Lily O'Hara

Challenges and Rewards of Health Research in Northern, Rural, and Remote Communities

by Kristen Jacklin

Telecommunications and Medicine: The Development of Telemedicine in Improving Access to Health Care in Rural Areas of East Tennessee

by Teresa Welsh

Online paper (1999)

Book- Ecosystems and human health: A critical approach to ecohealth research and practice -http://www.springer.com/public+health/book/978-1-4419-0205-4

by Crescentia Dakubo

C.Y. Dakubo, PhD. Ontario, Canada
Ecosystems and Human Health : A Critical Approach to Ecohealth Research and Practice.

The first book to draw on poststructuralist political ecology to give the reader an
understanding of how people-environment relations and health outcomes are shaped
by the interplay of power, culture, globalization, and socio-political forces.

Applies a participatory action research process to the field of ecohealth. Examines the challenges faced by students and researchers in designing and executing an Ecohealth project
and provides some practical tools.

The magnitude of current epidemics, environmental disasters, and extreme weather events is proving that human health... more The magnitude of current epidemics, environmental disasters, and extreme weather events is proving that human health problems require more comprehensive solutions than conventional biomedical approaches can offer. At the intersection of the public and community health, global health, and environmental fields, Ecohealth advocates improved health outcomes through better ecosystems management. But even as the Ecohealth approach gains acceptance, literature on the subject is scarce. Ecosystems and Human Health introduces Ecohealth as an emerging field of study, traces its evolution, and explains its applications in cross-disciplinary and holistic programs. Its integrative approach not only focuses on managing the environment to improve health, but also analyzes underlying social and economic determinants of health to develop innovative, people-centered interventions. This unique text:

• Expands on the theoretical systems that underlie Ecohealth.
• Examines the relationships between human health and the biophysical, political, cultural, and socioeconomic environments. • Discusses the methodological issues and the participatory action research process associated with Ecohealth.
• Provides detailed case studies illustrating the approach in developing and developed areas of the world.
• Suggests applications of Ecohealth methods to influence public health policy.
• Offers practical tools for readers designing and carrying out Ecohealth projects.
• Proposes a critical approach to Ecohealth research and practice.

Ecohealth holds vital keys to pressing global concerns, giving Ecosystems and Human Health a particular urgency for researchers, students, policymakers, and community and public health practitioners.

Accessing Social Services in Rural Canada: The Need for Public Transportation

by Eric Marr

Paper written for RPD 6390: Rural Social Policy Planning on the need for public transportation in accessing social services within the context of rural Canada.

Project HEAL (Healthy Eating and Activity for Life): Proposing a faith-based health education and lifestyle intervention for rural African Americans

by Natasha Brown

Men out bush: the health issues for men in rural South Australia: informing the South Australian men's health policy

by Ben Wadham

Turning on the Care Coordination Switch in Rural Primary Care: Voices from the Practices - Clinician Champions, Clinician Partners, Administrators, and Nurse Care Managers.

by Molly King

Fagnan, Lyle J., David A. Dorr, Melinda Davis, Paul McGinnis, Jo Mahler, Molly McCarthy King, LeAnn Michaels. 2011. The Journal of Ambulatory Care Management 34(3): 3014-318.

This study sought to understand the acceptability and feasibility of office-based nurse care management in medium to... more This study sought to understand the acceptability and feasibility of office-based nurse care management in medium to large rural primary care practices. A qualitative assessment of Care Management Plus (a focused medical home model for complex patients) implementation was conducted using semistructured interviews with 4 staff cohorts. Cohorts included clinician champions, clinician partners, practice administrators, and nurse care managers. Seven key implementation attributes were: a proven care coordination program; adequate staffing; practice buy-in; adequate time; measurement; practice facilitation; and functional information technology. Although staff was positive about the care coordination concept, model acceptability was varied and additional study is required to determine sustainability.

Securing and retaining a mental health workforce in Far Western New South Wales. Perkins D, Larsen L, Lyle D & Burns P. (2007). Aust J Rural Health. 2007 Apr ;15 (2):94-8.

by Pippa Burns

OBJECTIVE: To identify strategies local managers can use to optimise recruitment and retention of mental health staff... more OBJECTIVE: To identify strategies local managers can use to optimise recruitment and retention of mental health staff in rural locations.

DESIGN: Forty-one staff were interviewed about factors that attracted them to work in remote locations, their initial intentions and factors that encourage them to stay.

SETTING: The former Far West Health Area of New South Wales.

RESULTS: Overall job satisfaction was high (68%). Key attractors were rural lifestyle and environment. Family reasons, the field of work and the rural lifestyle were factors that keep staff in their positions. Some mentioned the desire to achieve professional goals and see projects completed. Many staff reported that their initial intentions to stay had remained the same (43.9%). Reasons for extended intention to stay were: greater career opportunities; a desire to complete professional goals; extension of positions; and personal factors. The most common reason for leaving was better career opportunities. Other reasons included: changes to personal commitments; heavy workloads or burnout; service management; and workplace politics. A large number of respondents mentioned key differences when comparing rural and metropolitan areas: more travel (greater distances); less service options for referral; greater spectrum of illnesses and conditions; more autonomy and responsibility.

CONCLUSIONS: Strategies to recruit and retain staff must take account of personal needs and aspirations. While there is room for state strategies to improve employment incentives, there is also considerable scope for local managers to improve the design and attractiveness of jobs.